Reduced-pressure wound dressings and systems for re-epithelialization and granulation

ABSTRACT

Methods, apparatuses, and systems for promoting re-epithelialization and granulation as an aspect of wound healing are presented. A method and system for promoting granulation and re-epithelialization of a wound at the same time involves using a reduced-pressure treatment dressing and applying a moist, water-sensitive barrier to promote re-epithelialization and to inhibit granulation. Other systems, apparatuses, and methods are presented.

RELATED APPLICATION

The present invention claims the benefit, under 35 USC §119(e), of thefiling of U.S. Provisional Patent Application Ser. No. 61/237,504entitled “Reduced-Pressure Wound Dressings and Systems ForRe-Epithelialization and Granulation,” filed Aug. 27, 2009, which isincorporated herein by reference for all purposes.

BACKGROUND

The present disclosure relates generally to medical treatment systemsand, in particular but not by way of limitation, to reduced-pressurewound dressings, systems, and methods for re-epithelialization andgranulation of a wound.

The physiological process of wound healing involves different phasesthat may occur simultaneously or sequentially. As used herein, “or” doesnot require mutual exclusivity. Two phases of the wound healing processinvolve granulation (proliferation) and re-epthiliazation.

SUMMARY

Improvements to certain aspects of wound care dressings, methods, andsystems are addressed by the present invention as shown and described ina variety of illustrative, non-limiting embodiments herein. According toan illustrative, non-limiting embodiment, a method for promotinggranulation and re-epithelialization of a wound includes the steps ofproviding a reduced-pressure treatment dressing having a first side anda second, tissue-facing side. The second, tissue-facing side of thereduced-pressure treatment dressing has a micro-strain inducing surface.The method further includes the steps of creating a moist,water-sensitive barrier on portions of the wound to promotere-epithelialization and to inhibit granulation; placing thereduced-pressure treatment dressing adjacent to the wound; and causing afluid seal over the reduced-pressure treatment dressing. The method alsoincludes applying reduced pressure to the reduced-pressure treatmentdressing.

According to an illustrative, non-limiting embodiment, a system forpromoting granulation and re-epithelialization of a wound of a patientincludes a reduced-pressure treatment dressing and a moist,water-sensitive barrier disposed adjacent the reduced-pressure treatmentdressing at portions of the wound to promote re-epithelialization and toinhibit granulation. The system further includes a sealing member forplacing over the reduced-pressure treatment dressing and a portion ofepidermis of the patient and a reduced-pressure source for providingreduced pressure to the reduced-pressure treatment dressing.

According to an illustrative, non-limiting embodiment, a kit fordeploying a dressing for promoting granulation and re-epithelializationof a wound of a patient includes a reduced-pressure treatment dressingand a water-sensitive, flowable material for disposing adjacent to thereduced-pressure treatment dressing at portions of the wound to promotere-epithelialization and to inhibit granulation. The kit also includes asealing member for placing over the reduced-pressure treatment dressingand a portion of epidermis of the patient. The kit may also include areduced-pressure delivery conduit for providing reduced pressure to thereduced-pressure treatment dressing. Finally, the kit includes adelivery device for applying the water-sensitive, flowable material.

Other features and advantages of the illustrative, non-limitingembodiments will become apparent with reference to the drawings anddetailed description that follow.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic diagram with a portion in cross section of anillustrative, non-limiting embodiment of a system and dressing forre-epithelialization and granulation of a wound;

FIG. 2 is a schematic, cross-sectional view of a wound to which a moist,water-sensitive barrier is being applied to a portion of the tissue;

FIG. 3 is a schematic, perspective view of water-sensitive, flowablematerial being applied to a reduced-pressure treatment dressing; and

FIG. 4 is a schematic, perspective view of an illustrative, non-limitingembodiment of a wound dressing.

DETAILED DESCRIPTION

In the following detailed description of the illustrative, non-limitingembodiments, reference is made to the accompanying drawings that form apart hereof. These embodiments are described in sufficient detail toenable those skilled in the art to practice the invention, and it isunderstood that other embodiments may be utilized and that logicalstructural, mechanical, electrical, and chemical changes may be madewithout departing from the spirit or scope of the invention. To avoiddetail not necessary to enable those skilled in the art to practice theembodiments described herein, the description may omit certaininformation known to those skilled in the art. The following detaileddescription is not to be taken in a limiting sense, and the scope of theillustrative embodiments are defined only by the appended claims.

Referring now primarily to FIG. 1, an illustrative, non-limitingembodiment of a wound treatment system 100 that facilitates granulationand re-epithelialization is presented. The system 100 is shown deployedfor treatment of a tissue site 102 and, in particular, a wound 104. Thewound 104 is shown extending through epidermis 112 and into subcutaneoustissue 114. A peri-wound area may include the wound 104 and intacttissue near the wound 104 or may include the wound 104 alone. The tissuesite 102 may be the bodily tissue of any human, animal, or otherorganism, including bone tissue, adipose tissue, muscle tissue, dermaltissue, vascular tissue, connective tissue, cartilage, tendons,ligaments, or any other tissue. The wound treatment system 100facilitates re-epithelialization of a portion of the tissue site 102 andfacilitates granulation of another portion of the tissue site 102 withboth potentially occurring at the same time. The wound 104 may havewound edges 106 and may include one or more islands of intact epidermis,such as island 108 of intact epidermis, which has wound edges 110. Thewound 104 may be regarded as including wound edges 106, 110.

The epithelialization, or re-epithelialization, phase of acute woundhealing involves resurfacing of the wound 104 and changes in the woundedges 106, 110. The process protects a patient's body from invasion byoutside organisms and may occur concurrently with other phases if notrestricted. The resurfacing aspect involves keratinocytes.

Among other things, keratinocytes form layers of the dermis andepidermis. Keratinocytes are derived from epidermal stem cells locatedin the bulge area of hair follicles and migrate from that location intothe basal layers of epidermis. The keratinocytes proliferate anddifferentiate to produce epidermis and thereby replenish the epidermis.Keratinocytes may respond to signals released from growth factors, whichmay be in wound exudate, by advancing in a sheet to resurface a space.Because of this migration, a moist wound environment may speed themigration of keratinocytes toward one another from the wound edges 106,110. The wound treatment system 100 promotes the re-epithelializationphase or process and the granulation phase or process.

The wound treatment system 100 includes a moist barrier 116, areduced-pressure treatment dressing 118, and a sealing member 120. Whenthe wound treatment system 100 is deployed, the reduced-pressuretreatment dressing 118 will be disposed adjacent to portions of thetissue site 102 where primarily granulation is desired and adjacent themoist barrier 116 in other locations. The moist barrier 116 will beadjacent to portions of the tissue site 102 where primarilyre-epithelialization is to be promoted and where granulation is to beinhibited or not facilitated. Among other things, the moist barrier 116reduces or prevents reduced pressure from being experienced at thelocation covered by the moist barrier 116 or reduces or prevents contactby a micro-strain-inducing surface of a manifold 128 of thereduced-pressure treatment dressing 118.

After the moist barrier 116 is deployed at the desired location, e.g.,the wound edges 106, 110, and the reduced-pressure treatment dressing118 is placed over the tissue site 102 and the moist barrier 116, thesealing member 120 is deployed. The sealing member 120 is deployed overthe reduced-pressure treatment dressing 118 and a portion of a patient'sintact epidermis 112.

The sealing member 120 has a first side 121 and a second, tissue-facingside 123. The sealing member 120 may be formed from any material thatprovides a fluid seal. “Fluid seal,” or “seal,” means a seal adequate tomaintain reduced pressure at a desired site given the particularreduced-pressure source or subsystem involved. The sealing member may,for example, be an impermeable or semi-permeable, elastomeric material.“Elastomeric” means having the properties of an elastomer. Elastomergenerally refers to a polymeric material that has rubber-likeproperties. More specifically, most elastomers typically have ultimateelongations greater than 100% and a significant amount of resilience.The resilience of a material refers to the material's ability to recoverfrom an elastic deformation. Examples of elastomers may include, but arenot limited to, natural rubbers, polyisoprene, styrene butadiene rubber,chloroprene rubber, polybutadiene, nitrile rubber, butyl rubber,ethylene propylene rubber, ethylene propylene diene monomer,chlorosulfonated polyethylene, polysulfide rubber, polyurethane, EVAfilm, co-polyester, and silicones. Additional examples of sealing membermaterials include a silicone drape, 3M Tegaderm® drape, polyurethane(PU) drape such as one available from Avery Dennison Corporation ofPasadena, Calif.

An attachment device 122 may be used to form a fluid seal between theepidermis 112 and the sealing member 120. The attachment device 122 maybe used to hold the sealing member 120 against the patient's epidermis112 or another layer, such as a gasket or additional sealing member. Theattachment device 122 may take numerous forms. For example, theattachment device 122 may be a medically acceptable, pressure-sensitiveadhesive 124 that extends about a periphery of the sealing member 120.

The reduced-pressure treatment dressing 118, which has a first side 130and a second, tissue-facing side 132, may be any dressing thatdistributes reduced pressure and that may help promote micro-strain atthe tissue site 102. For example, the reduced-pressure treatmentdressing 118 may be or include the manifold 128. The term “manifold” asused herein generally refers to a substance or structure that isprovided to assist in applying reduced pressure to, delivering fluidsto, or removing fluids from the tissue site 102. The manifold 128typically includes a plurality of flow channels or pathways thatdistribute fluids provided to and removed from the tissue site 102around the manifold 128. In one illustrative, non-limiting embodiment,the flow channels or pathways are interconnected to improve distributionof fluids provided or removed from the tissue site 102. The manifold 128may be a biocompatible material that is capable of being placed incontact with the tissue site 102 and distributing reduced pressure tothe tissue site 102.

Examples of the manifold 128 may include, for example, withoutlimitation, devices that have structural elements arranged to form flowchannels, such as, for example, cellular foam, open-cell foam, poroustissue collections, liquids, gels, and foams that include, or cure toinclude, flow channels. The manifold 128 may be porous and may be madefrom foam, gauze, felted mat, or any other material suited to aparticular biological application. In one embodiment, the manifold 128is a porous foam and includes a plurality of interconnected cells orpores that act as flow channels. The porous foam may be a polyurethane,open-cell, reticulated foam, such as GranuFoam® material manufactured byKinetic Concepts, Incorporated of San Antonio, Tex. Other embodimentsmay include “closed cells.” The manifold 128 has a first side 129 and asecond, tissue-facing side 131. The second, tissue-facing side 131 mayprovide a micro-strain-inducing surface, such as open cells orprotrusions or other devices that impinge on the tissue site 102 whenunder reduced pressure or a force.

In one embodiment, the manifold 128 may be constructed frombioresorbable materials that do not have to be removed from a patient'sbody following use of the reduced-pressure treatment dressing 118.Suitable bioresorbable materials may include, without limitation, apolymeric blend of polylactic acid (PLA) and polyglycolic acid (PGA).The polymeric blend may also include without limitation polycarbonates,polyfumarates, and capralactones. The manifold 128 may further serve asa scaffold for new cell-growth, or a scaffold material may be used inconjunction with the manifold 128 to promote cell-growth. A scaffold isa substance or structure used to enhance or promote the growth of cellsor formation of tissue, such as a three-dimensional porous structurethat provides a template for cell growth. Illustrative examples ofscaffold materials include calcium phosphate, collagen, PLA/PGA, coralhydroxy apatites, carbonates, or processed allograft materials.

In some situations, the manifold 128 may also be used to distributefluids, such as medications, antibacterials, growth factors, and varioussolutions to the tissue site 102. Other layers may be included in or onthe manifold 128, such as absorptive materials, wicking materials,hydrophobic materials, and hydrophilic materials.

A reduced-pressure connector 134 may be associated with thereduced-pressure treatment dressing 118 to provide reduced pressurethereto. The reduced-pressure connector 134 may have a flange portion136 that may be disposed between the sealing member 120 and the firstside 130 of the reduced-pressure treatment dressing 118. A portion ofthe reduced-pressure connector 134 extends through a connector aperture138 in the sealing member 120. A reduced pressure delivery conduit 140may be used to fluidly couple the reduced-pressure connector 134 to areduced-pressure source 142. One or more devices 144 may be associatedor fluidly coupled to the reduced-pressure delivery conduit 140. Thedevice or devices 144 that may be fluidly coupled to thereduced-pressure delivery conduit 140 include, for example, withoutlimitation, a fluid reservoir or collection member to hold exudates andother fluids removed, a pressure-feedback device, a volume detectionsystem, a blood detection system, an infection detection system, a flowmonitoring system, a temperature monitoring system, or other device.

The reduced-pressure source 142 provides reduced pressure as a part ofthe system 100. The term “reduced pressure” as used herein generallyrefers to a pressure less than the ambient pressure at a tissue sitethat is being subjected to treatment. In most cases, this reducedpressure will be less than the atmospheric pressure at which the patientis located. Alternatively, the reduced pressure may be less than ahydrostatic pressure of tissue at the tissue site. Although the terms“vacuum” and “negative pressure” may be used to describe the pressureapplied to the tissue site, the actual pressure applied to the tissuesite may be significantly more than the pressure normally associatedwith a complete vacuum. Unless otherwise indicated, values of pressurestated herein are gauge pressures.

The reduced pressure delivered by the reduced-pressure source 142 may beconstant or varied (patterned or random) and may be deliveredcontinuously or intermittently. In order to maximize patient mobilityand ease, the reduced-pressure source 142 may be a battery-powered,reduced-pressure generator. This facilitates application in theoperating room and provides mobility and convenience for the patientduring the rehabilitation phase. Other sources of reduced pressure mightbe utilized, such as V.A.C.® therapy unit, which is available from KCIof San Antonio, Tex., wall suction, a mechanical unit, or a micro-pumpimbedded in the reduced-pressure treatment dressing 118. The pressuremay in the range of −5 mm Hg to −500 mm Hg and more typically between−100 mm Hg and −200 mm Hg.

The reduced pressure developed by the reduced-pressure source 142 isdelivered through the reduced-pressure delivery conduit 140, or medicalconduit or tubing, to the reduced-pressure connector 134. A hydrophobicmembrane filter may be interspersed between the reduced-pressuredelivery conduit 140 and the reduced-pressure source 142. In anotherillustrative embodiment, reduced pressure is delivered by a micro-pumpto a sealed spaced under the sealing member 120.

The moist barrier 116 may be formed from numerous materials. In oneillustrative, non-limiting embodiment, the moist barrier 116 is a moist,water-sensitive barrier, such as a hydrogel, hydrocolloid, or other partsolid solution. The moist barrier 116 may also be a substance in a foamformulation such as a hydrogel or hydrocolloid foam form or may be anemulsified oil. The material from which the moist barrier 116 is formedmay be water-sensitive, or a fluid balancing material, meaning that thematerial will provide moisture to dry wounds and will absorb moisturefrom excessively moist, or wet, wounds. In one illustrative,non-limiting embodiment, the moist barrier 116 may be a water-sensitive,flowable material 146, such as a flowable hydrogel or flowablehydrocolloid. The moist barrier 116 may include additional substances,such as growth factors. The moist barrier 116 may promote bio-mimicry.

The water-sensitive, flowable material 146 may be a high viscosityfluid, like a flowable hydrogel or hydrocolloid that is low enough inviscosity to flow, but high enough in viscosity to occlude thereduced-pressure treatment dressing 118. The water-sensitive, flowablematerial 146 may move partially into the manifold 128. The degree towhich the water-sensitive, flowable material 146 moves into the manifold128 is, in the case of a foam manifold, governed primarily by pore size,the level of reduced pressure, and the viscosity of the water-sensitive,flowable material 146. For example, with a relatively viscous embodimentof the water-sensitive, flowable material 146 against a fine pore sizefoam, a majority of the water-sensitive, flowable material 146 willremain at the interface of the water-sensitive, flowable material 146and the foam.

As an illustrative, non-limiting example, the water-sensitive, flowablematerial 146 may have a viscosity in the range of 2,000 to 250,000centipoise (cP) at 25° C. As another illustrative, non-limiting example,the water-sensitive, flowable material 146 may have a viscosity in therange of 50,000 to 150,000 cP at 25° C. In another illustrative,embodiment, the water-sensitive, flowable material 146 may be a gel thatis pseudoplastic (capable of shear thinning, i.e., shear dependentviscosity) so that the material has a low viscosity as dispensed withhigh shear, but once in place with a low shear situation, the materialincreases in viscosity.

The moist barrier 116 is typically deployed in a position to cover thewound edges 106, 110 and may be deployed in a number of ways. Referringnow primarily to FIG. 2, one illustrative, non-limiting description of aprocess for forming the moist barrier 116 is presented. In thisillustrative example, the moist barrier 116 comprises thewater-sensitive, flowable material 146. A delivery device 150, such as asquirtable container of material, a syringe 152, or other device, isused to deliver the water-sensitive, flowable material 146 directly toportions of the tissue site 102 where granulation is not desired, butre-epithelialization is desired. In this way, the moist barrier 116 isformed in situ. The water-sensitive, flowable material 146 may provide amoist environment for the portions of the tissue site 102 that arecovered by the water-sensitive, flowable material 146, and thewater-sensitive, flowable material 146 restricts or prevents reducedpressure from being delivered through the reduced-pressure treatmentdressing 118 to the covered tissue or otherwise prevents micro-strainfrom being induced at the covered locations. In the illustrative examplein which the reduced-pressure treatment dressing 118 is formed from anopen cell foam, the water-sensitive, flowable material 146 may occludecells that contact the water-sensitive, flowable material 146.

Referring now primarily to FIG. 3, another illustrative, non-limitingexample of how the moist barrier 116 may be formed is presented. In thisillustrative, non-limiting embodiment, the delivery device 150, e.g.,the syringe 152, is used to apply a water-sensitive, flowable material146 onto the second, tissue-facing side 131 of the manifold 128. Thewater-sensitive, flowable material 146 is applied at locations on thesecond, tissue-facing side 131 of the manifold 128 that correspond oralign, when deployed, with the portions of the tissue site 102 wheregranulation is not desired and re-epithelialization is desired. Thus,once the water-sensitive, flowable material 146 is applied to thesecond, tissue-facing side 131 of the manifold 128 and the manifold 128is deployed adjacent to the tissue site 102, only the desired portionsof the tissue site 102 will receive reduced pressure in operation.

Referring now primarily to FIG. 4, still another illustrative,non-limiting example of how the moist barrier 116 may be formed ispresented. In this illustrative example, a layer 154 of water-sensitivematerial is applied to the second, tissue-facing side 131 of themanifold 128 and substantially covers the second, tissue-facing side 131of the manifold 128. The layer 154 includes perforations or cuts 156that readily allow one to remove one or more segments, or portions 158,of the layer 154 to expose a portion of the second, tissue-facing side131 of the manifold 128. As such, the segments 158 may be removed thatcorrespond, when deployed, to portions of the tissue site 102 wheregranulation is desired. When the reduced-pressure treatment dressing 118is deployed with the second, tissue-facing side 131 adjacent the tissuesite 102, the remaining portions of the layer 154 that form the moistbarrier 116 will be adjacent to the areas where no granulation isdesired but re-epthiliazation is desired. At the same time, the second,tissue-facing side 131 of the manifold 128 will be against the portionsof the tissue site 102 where granulation is desired.

According to one illustrative, non-limiting embodiment, the moistbarrier 116 may be formed from a hydrogel, hydrocolloid, or othermaterial. In this embodiment, the hydrogel or hydrocolloid may be castonto a woven liner and cross-linked. In this illustrative embodiment,the hydrogrel or hydrocolloid is not mobile.

According to one illustrative, non-limiting method of deploying thewound treatment system 100, the moist barrier 116 is placed adjacent tothe portion of the tissue site 102 where granulation is not desired andwhere re-epithelialization is desired. The second, tissue-facing side131 of the manifold 128 is placed directly adjacent to the portion ofthe tissue site 102 where granulation is desired. The sealing member 120is placed over the tissue site 102 and a portion of the patient's intactepidermis 112 to form a fluid seal. Reduced pressure is supplied to themanifold 128.

A kit for deploying a dressing for promoting granulation andre-epithelialization of a wound of a patient may be formed that providesan easy and convenient manner to treat a wound. The kit may include areduced-pressure treatment dressing (e.g., reduced-pressure treatmentdressing 118) and a water-sensitive, flowable material (e.g.,water-sensitive, flowable material 146) for disposing adjacent to thereduced-pressure treatment dressing (e.g., reduced-pressure dressing118) at locations on the wound where granulation is not desired andwhere re-epithelialization is desired. The kit also may include asealing member (e.g., sealing member 120) for placing over thereduced-pressure treatment dressing and a portion of epidermis of thepatient and may include a reduced-pressure delivery conduit (e.g.,reduced-pressure delivery conduit 140) for providing reduced pressure tothe reduced-pressure treatment dressings. The kit may include a deliverydevice (e.g., delivery device 150) for applying the water-sensitive,flowable material and may include a reduced-pressure connector (e.g.,reduced-pressure connector 134).

Although the present invention and its advantages have been disclosed inthe context of certain illustrative, non-limiting embodiments, it shouldbe understood that various changes, substitutions, permutations, andalterations can be made without departing from the scope of theinvention as defined by the appended claims. It will be appreciated thatany feature that is described in a connection to any one embodiment mayalso be applicable to any other embodiment.

1. A method for promoting granulation and re-epithelialization of awound of a patient, the method comprising the steps of: providing areduced-pressure treatment dressing having a first side and a second,tissue-facing side, wherein the second, tissue-facing side has amicro-strain inducing surface; creating a moist, water-sensitive barrieron at least a portion of the wound to promote re-epithelialization andto inhibit granulation; placing the reduced-pressure treatment dressingover a peri-wound area such that the reduced-pressure treatment dressingcovers at least a portion of the wound and at least a portion of themoist, water-sensitive barrier; forming a fluid seal over thereduced-pressure treatment dressing and a portion of epidermis of thepatient; and applying reduced pressure to the reduced-pressure treatmentdressing.
 2. The method for promoting granulation andre-epithelialization of a wound of claim 1, wherein the step of creatinga moist, water-sensitive barrier comprises the step of creating a moist,water-sensitive barrier over wound edges of the wound.
 3. The method forpromoting granulation and re-epithelialization of a wound of claim 1,wherein the step of creating a moist, water-sensitive barrier comprisesthe step of deploying a water-sensitive, flowable material.
 4. Themethod for promoting granulation and re-epithelialization of a wound ofclaim 1, wherein the step of creating a moist, water-sensitive barriercomprises the step of deploying a water-sensitive, flowable material onthe at least a portion of the wound to promote re-epithelialization andto inhibit granulation; and wherein the water-sensitive, flowablematerial has a viscosity in the range of 50,000 to 150,000 cP at 25° C.5. The method for promoting granulation and re-epithelialization of awound of claim 1, wherein the reduced-pressure treatment dressingcomprises a layer of removable, moist water-sensitive barrier materialon a manifold, and wherein the step of creating a moist, water-sensitivebarrier comprises the steps of removing a portion of the removable,moist water-sensitive barrier material from the manifold at a locationto promote granulation on a portion of the wound.
 6. The method forpromoting granulation and re-epithelialization of a wound of claim 1,wherein the micro-strain inducing surface is an open-cell foam.
 7. Themethod for promoting granulation and re-epithelialization of a wound ofclaim 1, wherein the step of creating a moist, water-sensitive barriercomprises the step of deploying a water-sensitive, flowable material toinhibit granulation and to promote re-epithelialization; and wherein thewater-sensitive, flowable material is a hydrogel.
 8. The method forpromoting granulation and re-epithelialization of a wound of claim 1,wherein: creating a moist, water-sensitive barrier comprises deploying awater-sensitive, flowable material to align with locations to inhibitgranulation and to promote re-epithelialization; the water-sensitive,flowable material comprises a hydrogel having a viscosity in the rangeof 50,000 to 150,000 cP at 25° C.; deploying a water-sensitive, flowablematerial comprises using a syringe to deliver the water-sensitive,flowable material onto the micro-strain inducing surface on portionsthat will interface with tissue to promote re-epithelialization and toinhibit granulation.
 9. The method for promoting granulation andre-epithelialization of a wound of claim 1, wherein the step ofdeploying a water-sensitive, flowable material comprises using a syringeto deliver the water-sensitive, flowable material onto the micro-straininducing surface on portions that will interface with tissue wherere-epithelialization is desired and granulation is not desired.
 10. Themethod for promoting granulation and re-epithelialization of a wound ofclaim 1, wherein: the step of creating a moist, water-sensitive barriercomprises the step of deploying a water-sensitive, flowable material toalign with locations where granulation is not desired; thewater-sensitive, flowable material comprises a hydrogel; and the step ofdeploying a water-sensitive, flowable material comprises using adelivery device to deliver the water-sensitive, flowable material ontotissue where re-epithelialization and not granulation is desired.
 11. Asystem for promoting granulation and re-epithelialization of a wound ofa patient, the system comprising: a reduced-pressure treatment dressinghaving a first side and a second, tissue-facing side, wherein thesecond, tissue-facing side has a micro-strain inducing surface; a moist,water-sensitive barrier disposed adjacent to the reduced-pressuretreatment dressing at locations to promote re-epithelialization and toinhibit granulation; a sealing member for placing over thereduced-pressure treatment dressing and a portion of epidermis of thepatient; and a reduced-pressure source for providing reduced pressure tothe reduced-pressure treatment dressing.
 12. The system of claim 11,wherein the moist, water-sensitive barrier comprises a water-sensitive,flowable material aligned with portions of the wound to promotere-epithelialization and to inhibit granulation.
 13. The system of claim11, wherein the moist, water-sensitive barrier comprises awater-sensitive, flowable material aligned with portions of the wound topromote re-epithelialization and to inhibit granulation, and wherein thewater-sensitive, flowable material is a hydrogel.
 14. The system ofclaim 11, wherein the reduced-pressure treatment dressing comprises alayer of removable, moist water-sensitive barrier on a manifold, andwherein the removable, moist water-sensitive barrier is absent onportions of the manifold on a tissue-facing surface to promotegranulation.
 15. The system of claim 11, wherein the micro-straininducing surface is an open-cell foam.
 16. The system of claim 11,wherein the micro-strain inducing surface is a gauze.
 17. A kit fordeploying a dressing for promoting granulation and re-epithelializationof a wound of a patient, the kit comprising: a reduced-pressuretreatment dressing having a first side and a second, tissue-facing side,wherein the second, tissue-facing side has a micro-strain inducingsurface; a water-sensitive, flowable material for disposing adjacent tothe reduced-pressure treatment dressing and adjacent to portions of thewound to promote re-epithelialization and to inhibit granulation; asealing member for placing over the reduced-pressure treatment dressingand a portion of epidermis of the patient; and a delivery device forapplying the water-sensitive, flowable material.
 18. The kit of claim17, wherein delivery device comprises a syringe.
 19. The kit of claim17, wherein the water-sensitive, flowable material comprises a flowablehydrogel and the delivery device comprises a syringe.
 20. The kit ofclaim 17, wherein the water-sensitive, flowable material comprises aflowable hydrogel; the delivery device comprises a syringe; and whereinthe flowable hydrogel has a viscosity in the range of 50,000 to 150,000cP at 25° C.
 21. The kit of claim 17, further comprising areduced-pressure delivery conduit for providing reduced pressure to thereduced-pressure treatment dressings.